K C Bidur1, Devkota Upendra Prasad1. 1. Department of Neurosurgery, National Institute of Neurological and Allied sciences, Bansbari, Kathmandu, Nepal.
Abstract
INTRODUCTION: Debate continues as to the optimum treatment for craniopharyngioma; radical surgical resection or partial resection followed by radiotherapy. Radical surgical resection may be complicated by intraoperative injury to surrounding structures and stormy postoperative hormonal problem. This study aims to examine the result of safe maximal surgical resection. MATERIALS AND METHODS: Retrospective study of all histopathologically proven craniopharyngiomas who had undergone surgical resection over an almost 8 year period was included. Data were collected reviewing demography, clinical presentation, hormonal dysfunction, extent of resection and visual deterioration. Outcome was measured in terms of Glasgow outcome scale and recurrence. RESULTS: Of 25 patients, 68% were male, and 32% were female. Age of patients ranged from 7 to 58 years with a mean of 30.12 ± 16.42 years. Patients presented with visual deterioration were 76% and with a headache were 68%. Mean duration of symptoms was 10.64 ± 14.28 months. Gross total resection was done in 21 (84%), while subtotal resection in 4 (16%) who also received subsequent adjuvant radiotherapy. During the postoperative period, diabetes insipidus developed in 84% patients, but none had it permanently. Favorable outcome was found in 88% patients. However, there were 4% operative mortality with overall mortality of 8% and tumor recurrence in 8% patients. CONCLUSION: Gross total excision if judiciously decided intraoperatively has a favorable outcome with acceptable morbidity.
INTRODUCTION: Debate continues as to the optimum treatment for craniopharyngioma; radical surgical resection or partial resection followed by radiotherapy. Radical surgical resection may be complicated by intraoperative injury to surrounding structures and stormy postoperative hormonal problem. This study aims to examine the result of safe maximal surgical resection. MATERIALS AND METHODS: Retrospective study of all histopathologically proven craniopharyngiomas who had undergone surgical resection over an almost 8 year period was included. Data were collected reviewing demography, clinical presentation, hormonal dysfunction, extent of resection and visual deterioration. Outcome was measured in terms of Glasgow outcome scale and recurrence. RESULTS: Of 25 patients, 68% were male, and 32% were female. Age of patients ranged from 7 to 58 years with a mean of 30.12 ± 16.42 years. Patients presented with visual deterioration were 76% and with a headache were 68%. Mean duration of symptoms was 10.64 ± 14.28 months. Gross total resection was done in 21 (84%), while subtotal resection in 4 (16%) who also received subsequent adjuvant radiotherapy. During the postoperative period, diabetes insipidus developed in 84% patients, but none had it permanently. Favorable outcome was found in 88% patients. However, there were 4% operative mortality with overall mortality of 8% and tumor recurrence in 8% patients. CONCLUSION: Gross total excision if judiciously decided intraoperatively has a favorable outcome with acceptable morbidity.
Entities:
Keywords:
Craniopharyngioma; extent of resection; outcome
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